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SSNAP Governance

Contract and funding

The Sentinel Stroke National Audit Programme (SSNAP) is the national stroke audit for England, Wales, and Northern Ireland. Funded by the Healthcare Quality Improvement Programme (HQIP), SSNAP is now the single source of stroke data in England, Wales, and Northern Ireland. SSNAP’s current funding contract runs from April2012 – March 2018. More information about SSNAP’s funding body HQIP is available here: http://www.hqip.org.uk/.

Audit design

The SSNAP clinical audit is continuous. It collects data prospectively on all patients in England and Wales admitted to hospital following a stroke, from admission to 6 months after stroke. The audit covers the pathway across providers by transferring the electronic record on a password protected webtool. The webtool has been developed to measure against evidence based processes and outcomes of care. Data are of very high quality and completeness, which enable analysis at both team and patient centred level (patient centred level represents a "patient's eye" view of care quality across the whole stroke pathway). All patients with a primary diagnosis of stroke coded as I-61, I-63, I-64 should be submitted to SSNAP. The minimum age for patient submission to SSNAP is 16.

SSNAP Steering Group

SSNAP is overseen by the Intercollegiate Stroke Working Party (ICSWP). This comprises members from healthcare professions in the stroke care pathway, patient and carer representative organisations, stroke patients, and representatives from the Royal College of Physicians (RCP). Details of ICSWP membership is available here.

Collection of patient data

SSNAP currently has approval under Section 251 to collect patient level data on the first six months of patient care (ECC 6-02(FT3)/2012). More information on section 251 is available here: http://www.hra.nhs.uk/about-the-hra/our-committees/section-251/what-is-section-251/ The rationale for this legal basis is that many stroke patients are extremely unwell in the acute phase of their treatment and it is therefore not feasible to rely on patient consent during this time period.

Patient consent is explicitly sought at six months post-stroke though it can also be recorded during the patient’s inpatient stay. Where a patient refuses consent for inclusion in SSNAP, all their personal identifiable information will be wiped from the dataset and no further linkages to other data sources will therefore be possible, however their non-identifiable data will continue to be held on the database as it is important for the purpose of SSNAP to analyse all data without selection bias. The SSNAP team do not have access to patient identifiable information at any point in the patient pathway. See our data flow diagram here.